Philadelphia FIGHT Community Health Centers, Philadelphia, Pennsylvania, USA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Infect Dis. 2020 Nov 27;222(Suppl 9):S773-S781. doi: 10.1093/infdis/jiaa574.
The opioid epidemic in the United States, along with a lack of adequate harm reduction services, has contributed to a sharp rise in hepatitis C virus (HCV) infections. Despite considerable evidence of the effectiveness of HCV treatment in people who inject drugs (PWID), and recommendations from clinical guidelines to prioritize treatment in PWID, there are multiple barriers to broad uptake of HCV treatment. These barriers exist at the systems level, as well as at the level of medical providers and patients. Interventions to remove treatment barriers in the United States include harm reduction services, simplifying HCV testing algorithms, improved linkage to HCV care services, and application of new treatment models including colocating services at substance use disorder treatment programs. By following the lead of other countries who have addressed the barriers to HCV treatment, the United States has opportunities to do better in addressing the consequences of the opioid epidemic, including chronic HCV infection.
美国的阿片类药物泛滥，加上缺乏足够的减少伤害服务，导致丙型肝炎病毒（HCV）感染急剧上升。尽管有大量证据表明丙型肝炎病毒治疗在注射毒品者（PWID）中的有效性，以及临床指南建议优先为 PWID 治疗，但广泛采用 HCV 治疗仍存在多种障碍。这些障碍不仅存在于系统层面，还存在于医疗服务提供者和患者层面。为消除美国 HCV 治疗障碍而采取的干预措施包括减少伤害服务、简化 HCV 检测算法、加强与 HCV 护理服务的联系，以及应用新的治疗模式，包括在物质使用障碍治疗计划中设置联合服务。通过借鉴其他已经解决 HCV 治疗障碍的国家的经验，美国有机会更好地应对阿片类药物泛滥的后果，包括慢性 HCV 感染。
